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Pancreatitis, Chronic

Robert L. Frachtman, FACG, MD and Marni L. Martinez, APRN Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Long-standing and progressive fibro-inflammatory syndrome of the pancreas due to toxic, metabolic, genetic, autoimmune, obstructive and idiopathic mechanisms

  • Results in exocrine and/o...

DIAGNOSIS

As with acute pancreatitis, symptoms do not always correlate well with objective findings (imaging, amylase/lipase). 

HISTORY

  • Epigastric pain, often radiating to the back

  • Flare-ups may mimic ac...

TREATMENT

GENERAL MEASURES

  • Discontinue tobacco use (3).

  • Consider pain consultation for chronic opioid management.

  • Exocrine and endocrine replacement therapy (enzymes and insulin)

  • Consider advanced pain t...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Follow fasting blood glucose, as the development of type 3 diabetes is most likely related to the duration of disease. 

  • There is no evidence to suggest that pancre...

REFERENCES

1
Zhang CL, Wang JJ, Li JN, et al. Nonalcoholic fatty pancreas disease: an emerging clinical challenge. World J Clin Cases. 2021;9(23):6624–6638. doi: 10.12998/wjcc.v9.i23.6624.
2
Yang D, Fors...

ADDITIONAL READING

  • Conwell  DL, Lee  LS, Yadav  D, et al. American Pancreatic Association practice guidelines in chronic pancreatitis: evidence-based report on diagnostic gu...

SEE ALSO

Choledocholithiasis; Lupus Erythematosus, Systemic (SLE); Peptic Ulcer Disease; Substance Use Disorders 

CODES

ICD10

K86.1 Other chronic pancreatitis 
K86.0 Alcohol-induced chronic pancreatitis 

SNOMED

  • 235494005 Chronic pancreatitis (disorder)

  • 235952002 Alcohol-induced chronic pancreatitis (disorder)

  • 235954001...

CLINICAL PEARLS

  • EUS can help differentiate chronic pancreatitis from pancreatic cancer.

  • Pain management is a central component in managing chronic pancreatitis.

  • Assess for exocrine pancreatic insufficie...

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